Sandwiches Make Woman Get Pacemaker

Dec. 18, 2008 --Talk about an unusual side effect. Doctors in England recently treated a woman who reacted so badly to sandwiches and certain other foods that she needed a pacemaker.

The 25-year-old woman saw the doctors in January because she was having brief spells of feeling lightheaded (and sometimes fainting) several times a week and was feeling "alarmingly unwell," the doctors write in The Lancet.

The doctors -- who included cardiologist C.J. Boos, MRCP, of University Hospital Birmingham -- looked into her medical history and found it to be "unremarkable," just like her checkup.

"On questioning, she remarked that her episodes tended to occur when she ate certain kinds of food, especially sandwiches, or drank fizzy drinks," write the doctors, adding that the woman reported that the last time it happened, she had collapsed while driving and eating a sandwich.

The woman said she avoided eating because of the problem. She weighed only 102 pounds and wasn't quite heavy enough to have a normal BMI.

After ruling out anorexia nervosa, the doctors gave her a sandwich to see what happened. She didn't faint, but she said she felt lightheaded, and her EKG flattened out for a few seconds before she bounced back.

The problem wasn't a food allergy or mayonnaise past its prime. Instead, the diagnosis was "swallowing syncope." That is, swallowing would occasionally interfere with her vagus nerve, and that hampered her heart's electrical activity.

The patient wound up getting a pacemaker implanted in her heart to smooth out those problems. "She has not fainted since," her doctors write. "When last seen, in June 2008, she could eat sandwiches with impunity."